Permit ti CITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: PLM2012-00204
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/24/2015
Parcel: 1S134AB03300
Jurisdiction: Tigard
Site address: 10330 SW SCHOLLS FERRY RD
Project: Muslim Educational Trust Subdivision: ENGLEWOOD Lot: 88
Project Description: Interior plumbing for new 2-story building. 11/6/13,(29)floor drains and(1)ejector pump done under separate
permit, PLM2013-00400.
Contractor: WESTERN PLUMBING Owner: MUSLIM EDUCATIONAL TRUST INC
9460 SW TIGARD AVE SUITE 101 PO BOX 283
TIGARD, OR 97223 PORTLAND, OR 97223
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/14/2015 $31.27
Specifics: 1 ea Clothes Washer 07/14/2015 $25.02
1 ea Dishwasher 07/14/2015 $25.02
Type of Use: COM 4 ea Drinking Fountain 07/14/2015 $100.08
Class of Work: NEW 1 ea Expansion Tank 07/14/2015 $12.51
Type of Const: 1 ea Garbage Disposal 07/14/2015 $25.02
Occupancy Grp: 7 ea Hose Bib 07/14/2015 $175.14
Stories: 1 ea Interceptor/Grease Trap 07/14/2015 $25.02
8 ea Primer 07/14/2015 $100.08
2 ea Roof Drain(Commercial) 07/14/2015 $25.02
5 ea Sink 07/14/2015 $125.10
52 ea Lavatories 07/14/2015 $1,301.04
6 ea Tub/Shower/Shower Pan 07/14/2015 $75.06
25 ea Water Closet 07/14/2015 $625.50
2 ea Water Heater 07/14/2015 $75.04
25 Misc Other Fee 07/14/2015 $25.02
Total $4,176.74
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. -nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di ct questions to 01 C by c- 'ng 503.232.1987 or 1.800.332.2344.
Is.ued By: I Permittee Sig ature: ' ^
Call 503.639.4175 by 7:00 a.m.for the next available ins.• Lion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_ 1
Plumbing Permit Application ' Cj/f""
{)+i}}t es- • ` FOR t _CE USE ON I.1
MAY 2012 Received Q,, �A_'A ei_„/
City of Tigard MAY 0 2 12 Date/B : 30 /A Perini'No.: jjt(J 77�^(Xd/(CJf-
tI y 13125 SW Hall Blvd.,Tigard,OR w Plan Review C /� �]
Phone: 503.718.2439 Fax: 503. �F 1'rGAI,D Date/By: . ;� �� .+� Other Permit No.: -�D/t0�
T f GA Rt?
Inspection Line: 503.639.4175 C Il'DI 11t i Date Ready/B luny el See Page 2 for
Internet: www.tigard-ocgov `! NG DIVfSI N r Method:!l r /� sr'.krrental Information
0tr7= r.r1*« r74: f C w•£ .. -:-: '5 r� •c ,,.:,,,,,4,-,1„,,,,,-;,. ,-'Y ,�: V y 1
Jiu.€a,r 1r_ ,,.r rffir,4. c :° �k,1 s.1.. :,, s -.e,. 4;:2:avt - . J :ee r .su,4,i 4.+.r :• ._ , , . .y ,.xKdvl.1.. :
0 New construction ❑Demolition . ■ For special information use checklist
Description I Qty. I Ea. I Total
❑Addnton/alteratlon/replacement ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
x ![.�i, , r_, r r . - 'j-.,--i SFR(I)bath 312.70
❑ I-and 2-family dwelling ®Commeroial/industrial
SFR(2)bath 437.78 y
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
. ,i ,.ti. .r. J 1�.,x- 11.")._tk r.. o Wa . , a.. . ,4b.c:r"4`'r.ti- e u w i.,ti fie utilities: r
Job site address: 10330 SW Scholls Ferry Road Ca in or area drain
ilh City/State/ZIP:Tigard,OR 97223 Drywell,I ine,or trench drain PliP
Footing drain(no. . r ft.: ) Page 2 387.71
Suite/bldg./apt.no.: Project name:MET Community Center Manufactured home utili - 50.03
Cross street/directions to job site:SW Scholls Ferry&SW Conestoga Drive Manholes 4 18.76
Rain drain connec . 4 1...... 18.76
Sanitary se (no.1�l.Il�p �As= 175.10
fife
Sto • ewer( , ear ft..' ) Page 2 550.30
ater service(no.linear ft.: ,) Page 2 13 .
Subdivision: 1_ot no Fixture or item: _ /
Tax map/parcel no.:1S134AB03300 Backflow preventer I 31.27 31.27
1)a " # -:`t ' i , v-,---• :c - "i,,K :''" Backwater valve ' 12.51
Clothes washer I 25.02 25.02 .k...
New 2 story,partial basement private school l
o Dishwasher 1 25.02 25.02
6 0-r-titi0e. Pt...La-iL4l /Peso') Drinking fountain 4 r 25.02 100.08 ��
Ejectors/sump a...3-- 25.02 75.06 M
7 1 rtr m T .W, . r a'y , 2 ? T � � ;-,r_4 k , Expansion tank 1 12.51 12.51
Name:Muslim Educational Trust Fixture/sewer cap 25.02
Floor drain/floor sink/hub ',29r ' 25.02 725.58
Address: 10330 SW Scholls Ferry Road
Garbage disposal t r 25.02 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 7 25.02 175.N
I Phone:(503)579-6621 Fax:(503)590-0201 Ice maker 12.51
f r ,%- f-. �. .: E e.--r"(u q -a t;,.., '(v s3 x°� era + �`"# * r Interceptor/grease trap 1 25.02 25.02
Business name:Otak Architects,Inc Medical gas(value:$ ) Page 2
Primer 8 12.51 100.08
Contact name:Jennifer Nye Roof drain(commercial) 2 12.51 25.02
Address: 17355 SW Boones Ferry RD Sink/basin/lavatory 57 d 25.02 1426.14
1 City/State2iP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)699-2456 I Fax: :(503)635-5395 Tub/shower/shower pan 6 I 12.51 75.06
E-mail jennifer.nye@otak.com
Urinal 25.02
Water closet 25 25.02 625.50
-� �� CONTRACT02' ' w
; t.x i. x y_ 1; ..r,. "1-a R 5:(
Water heater 2 37.52 75.04
Business name: AA-17 7 'V P _j4.IIi3/IJG- W..at r,,,;•/ l-1 5b29 619 L9,.
Address: 9y4,0 -Cu) T/� 2A Off- Sib/0i Other: a L,.SA4U a- ( 25.02 .,5,0,"+. tee
City/State/ZIP: T7��/L� Oe 9.1��3 ' POOL. Pt 012. Subtotal 544645- 3
P1W1C:t 639-5a4‘. Fax:£ 3) 4,FI y /s Minimum permit fee. $72.50 e c
CY. Lic.: a y3 9 Plumbing Lic.no.: 3�/X9/0
Plan review (25%ofpermit fee) 134.441 i
/I► State surcharge(12%of permit fee) 649411. 4 1•
Auttttnit"ed signature: •' ' t TOTAL PERMIT FEE g470.53.�
unlR'.Yiilme: R0 1 PJr l Q l O 0 IV pate: /7/4 7/4 3 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. }�(/
*Fee methodology set by Trrii-County Building Industry Service Board. ' 1f i 14
r�wtya�hrtrib PtMtl.PermtApp doc 10/01/09 440-4616T(IW02/COM!WEB 1* //jG//3 6 9) ci-LOt 4-t NY`' c*(,) fife ril/ .i iP
PL,t-f i kt4otl'r, Age i�► 71ff 5 P 21-rtr 9 155"el)
Lib EL kl-f40-4 i3-co Lim' ' 'T1
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain- I" 100' I 50 03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 9 37.52 337.68 2,001 to 3,600 $169 69
3,601 to 7,200 $233.20
Sewer-1st 100' I 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 3 37.52 112.56
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 2 37.52 75 04
Valuation: _ Permit Fee:
Storm&Rain Drain-1st 100' I 62 54 62 54 $1.00 to$5,000.00 Minimum he$72.50
Storm&Rain Drain-each additional 100' 13 37 52 487 76 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
p and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90 00/hr $50,001 00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof
Subtotal:
Other Fixtures: 1 1 1
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantitj by Fixture Type
Fixture Type for Replace/ Plan Review for Plumbing Installations
Work Performed: Capped Added Relocate g
Baptistry/Font Plan review is required tier any of the following.
Bath -Tub/Shower P ase check all that apply.
-Jacuzzi/Whirlpool Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial I i as defined in OAR918-780-0040.
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain 4 , ❑ Any multipurpose fire sprinkler system.
Eye Wash I ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2" 19
ID ?4;4'. '' Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain
Garbage -Domestic-non-food Isometric or Riser Diagram
Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings
-Commercial-food related 1 / that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig. Drains
Oil Separator(Gas Station) �� ��/��
Rec.Vehicle Dump Station om m tst regarding fixture work: . r .
Shower -Gang .vvl J � ,V.
-Stall 6 • t�[I�tl
Sink/Lay -Non-food related 52 / ( r 4'U � -Al •
-Bradley V
-Commercial-food related 4 /
-Service I •
Swimming Pool Filter I
Washer-Clothes 1 *Note: If the fixture under this permit results in an
Water Extractor ure wor uner p
Water Closet-Toilet 25 ' increase of sewer EDUs,a sewer permit will be issued and
Urinal _ fees assessed for the sewer increase must be paid before the
F:\MET\MITT Community Center\Technical Committee\City of Tigard\M2ior Modification_Building Permit Applications_May 2012\PLMU-
PermitApp.doc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00204
George Heimos
See Permit. PLM2013-00400 for all interior plumbing inspectioms
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00204
George Heimos
1. Science lab island vent re-assembled and pass. Rough/test with running water. Ok
2. Provide caulking on all science lab sinks. 407.2
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 13, 2015 at
11:02:44 AM
PLM2012-00204
Don Sylvester
1. Corrections are complete- plumb. Final ok
Violation Summary:
Inspector Contractor